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General NPI Number Information
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NPI Number | 1760134381
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Entity Type | Organization
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Legal Business Name | DECATUR MORGAN MEDICAL CARE
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Dates
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Enumeration Date | 01/25/2022
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 2422 DANVILLE RD SW STE D
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City | DECATUR
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State | AL
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Zip | 35603-4221
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Country | US
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Telephone | 256-355-8155
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 7TH ST SE
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City | DECATUR
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State | AL
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Zip | 35601-3337
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Country | US
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Telephone | 256-973-2162
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KELLI S POWERS
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Credential |
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Telephone | 256-973-2150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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